MACK PORTER

CERRITOS, CA
NPI1912568841
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy163WP0809X Registered Nurse, Psych/Mental Health, Adult
(Licence: CA  437831)
Enumeration Date2019-06-21
Last Update Date2019-06-21
Business Address
MACK PORTER RN
10802 COLLEGE PL
CERRITOS, CA 90703-1579
Phone number: 562-924-9581
Mailing Address
MACK PORTER RN
10802 COLLEGE PL
CERRITOS, CA 90703-1579
Phone number: 562-924-9581